<form id="edit-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Custom_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-custom_id" data-rule="required" data-source="custom/index" class="form-control selectpage" name="row[custom_id]" type="text" value="{$row.custom_id|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Acct_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-acct_id" data-rule="required" data-source="acct/index" class="form-control selectpage" name="row[acct_id]" type="text" value="{$row.acct_id|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Channel')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-channel" class="form-control" name="row[channel]" type="number" value="{$row.channel|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Assign')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-assign" class="form-control" name="row[assign]" type="number" value="{$row.assign|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Is_apply')}:</label>
        <div class="col-xs-12 col-sm-8">
                        
            <select  id="c-is_apply" class="form-control selectpicker" name="row[is_apply]">
                {foreach name="isApplyList" item="vo"}
                    <option value="{$key}" {in name="key" value="$row.is_apply"}selected{/in}>{$vo}</option>
                {/foreach}
            </select>

        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Apply_time')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-apply_time" class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:mm:ss" data-use-current="true" name="row[apply_time]" type="text" value="{:$row.apply_time?datetime($row.apply_time):''}">
        </div>
    </div>
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-primary btn-embossed disabled">{:__('OK')}</button>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
</form>
